Whether, when, and who to disclose bad news to patients with cancer: a survey in 150 pairs of hospitalized patients with cancer and family members in China

Psychooncology. 2012 Jul;21(7):778-84. doi: 10.1002/pon.1979. Epub 2011 Apr 20.

Abstract

Objective: The purpose of this study is to determine how to disclose bad news to patients with cancer in China.

Methods: One hundred fifty pairs of hospitalized patients and their family members were investigated using a self-designed questionnaire.

Results: More patients than their families believed that patients should be informed of their illnesses (98.0% vs. 66.7%, p < 0.001), that patients should be informed of their condition completely (69.3% vs. 18.7%, p < 0.001), that patients should be informed as soon as the diagnoses were confirmed (49.3% vs. 14.7%, p < 0.001), and that patients should be informed by doctors (55.3% vs. 10.7%, p < 0.001). κ coefficients between patients and their families on "whether, when and who to disclose" ranged from -0.084 to 0.004. Univariate logistic analyses demonstrated that farmer patients and patients with lower education and lower income were less likely to prefer to be informed completely; farmer patients and patients without an intended curative operation history were less likely to prefer to be informed immediately and directly by doctors. Multivariate analyses showed that farmer patients were less likely to prefer to be informed completely, immediately, and directly by doctors.

Conclusions: There was poor or slight concordance in disclosure preferences between patients with cancer and their families. More patients than their families wanted to be informed completely, immediately, and directly by doctors. Farmer patients with cancer were less likely to prefer to be informed completely, immediately, and directly by doctors.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Asian People / psychology*
  • Attitude to Health
  • China
  • Family / psychology*
  • Female
  • Health Care Surveys
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasms / diagnosis
  • Neoplasms / psychology*
  • Patient Preference*
  • Physician-Patient Relations
  • Professional-Family Relations
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Time
  • Truth Disclosure*
  • Young Adult